scholarly journals Radiographical researches on the topographical relations of the brain, the frontal and maxillary sinuses, and the venous sinuses of the dura mater to the walls of the skull

1901 ◽  
Vol 10 (2) ◽  
pp. 145-146
Author(s):  
Paul Regnier
Author(s):  
Jair Leopoldo Raso

Abstract Introduction The precise identification of anatomical structures and lesions in the brain is the main objective of neuronavigation systems. Brain shift, displacement of the brain after opening the cisterns and draining cerebrospinal fluid, is one of the limitations of such systems. Objective To describe a simple method to avoid brain shift in craniotomies for subcortical lesions. Method We used the surgical technique hereby described in five patients with subcortical neoplasms. We performed the neuronavigation-guided craniotomies with the conventional technique. After opening the dura and exposing the cortical surface, we placed two or three arachnoid anchoring sutures to the dura mater, close to the edges of the exposed cortical surface. We placed these anchoring sutures under microscopy, using a 6–0 mononylon wire. With this technique, the cortex surface was kept close to the dura mater, minimizing its displacement during the approach to the subcortical lesion. In these five cases we operated, the cortical surface remained close to the dura, anchored by the arachnoid sutures. All the lesions were located with a good correlation between the handpiece tip inserted in the desired brain area and the display on the navigation system. Conclusion Arachnoid anchoring sutures to the dura mater on the edges of the cortex area exposed by craniotomy constitute a simple method to minimize brain displacement (brain-shift) in craniotomies for subcortical injuries, optimizing the use of the neuronavigation system.


2021 ◽  
pp. 1118-1123
Author(s):  
Kengo Setta ◽  
Takaaki Beppu ◽  
Yuichi Sato ◽  
Hiroaki Saura ◽  
Junichi Nomura ◽  
...  

Malignant lymphoma of the head rarely arises outside of the brain parenchyma as primary cranial vault lymphoma (PCVL). A case of PCVL that invaded from subcutaneous tissue into the brain, passing through the skull, and occurred after mild head trauma is reported along with a review of the literature. The patient was a 75-year-old man with decreased activity. One month before his visit to our hospital, he bruised the left frontal area of his head. Magnetic resonance imaging showed homogeneously enhanced tumors with contrast media in the subcutaneous tissue corresponding to the head impact area and the cerebral parenchyma, but no obvious abnormal findings in the skull. A biopsy with craniotomy was performed under general anesthesia. The pathological diagnosis was diffuse large B-cell lymphoma. On histological examination, tumor cells grew aggressively under the skin. Tumor cells invaded along the emissary vein into the external table without remarkable bone destruction and extended across the skull through the Haversian canals in the diploe. Tumor cells were found only at the perivascular areas in the dura mater and extended into the brain parenchyma. Considering the history of head trauma and the neuroimaging and histological findings, the PCVL in the present case arose primarily under the skin, passed though the skull and dura mater, and invaded along vessels and reached the brain.


1989 ◽  
Vol 257 (1) ◽  
pp. H157-H161 ◽  
Author(s):  
F. M. Faraci ◽  
K. A. Kadel ◽  
D. D. Heistad

The goal of this study was to examine vascular responses of the dura mater. Microspheres were used to measure blood flow to the dura and brain in anesthetized dogs. Under control conditions, blood flow to the dura was 38 +/- 3 (SE) ml.min-1.100 g-1. Values for blood flow to the dura obtained with simultaneous injection of 15- and 50-microns microspheres were similar, which suggests that shunting of 15-microns spheres was minimal. Left atrial infusion of substance P (100 ng.kg-1.min-1) and serotonin (40 micrograms.kg-1.min-1), two agonists that have been reported to increase vascular permeability in the dura, increased blood flow to the dura two- to threefold. Adenosine (iv) produced vasodilatation in the dura. Adenosine and serotonin did not affect cerebral blood flow, but substance P increased blood flow to the brain by approximately 40%. Seizures, which produce pronounced dilatation of cerebral vessels despite activation of sympathetic nerves, produced vasoconstriction in the dura. Thus 1) the dura is perfused at a relatively high level of blood flow under normal conditions and is very responsive to vasoactive stimuli, and 2) substance P and serotonin, which have been implicated in the pathogenesis of vascular headache, produce pronounced vasodilator responses in the dura mater.


1901 ◽  
Vol 47 (199) ◽  
pp. 729-737 ◽  
Author(s):  
Joseph Shaw Bolton

This demonstration was a further report on the subject laid before the Association at the meeting at Claybury in February last, viz., the morbid changes occurring in the brain and other intra-cranial contents in amentia and dementia. In a paper read before the Royal Society in the spring of 1900, and subsequently published in the Philosophical Transactions, it was stated, as the result of a systematic micrometric examination of the visuo-sensory (primary visual) and visuo-psychic (lower associational) regions of the cerebral cortex, that the depth of the pyramidal layer of nerve-cells varies with the amentia or dementia existing in the patient. At the meeting of the Association referred to it was further shown, from an analysis, clinical and pathological, of 121 cases of insanity which appeared consecutively in the post-mortem room at Claybury, that the morbid conditions inside the skull-cap in insanity, viz., abnormalities in the dura mater, the pia arachnoid, the ependyma and intra-cranial fluid, etc., are the accompaniments of and vary in degree with dementia alone, and are independent of the duration of the mental disease. Since that date the pre-frontal (higher associational) region has been systematically examined in nineteen cases, viz., normal persons and normal aments (infants), and cases of amentia, of chronic and recurrent insanity without appreciable dementia, and of dementia, and the results obtained form the subject of the present demonstration. A paper on the whole subject will shortly be published in the Archives of the Claybury Laboratory.


2001 ◽  
Vol 19 (3) ◽  
pp. 491-495
Author(s):  
Mário Emílio Teixeira Dourado Júnior ◽  
Ricardo Humberto de Miranda Félix ◽  
Marcos Dias Leão

Introduction. Hypertrophic pachymeningitis (HP) is a rare inflammatory disease that results in thickening of the dura mater. Atypically, it can progress to include the involvement of the cerebral parenchyma. Method. In this paper, we report the rare case of a 31-year-old man with a three-week history of headaches, seizures, impairments of cognitive function, and changes in behavior and mood. Magnetic resonance imaging (MRI) of the brain showed a thickening and an abnormal enhancement of the dura mater over the falx cerebri with extensions into the adjacent cranial base and with brain edemas in the frontal lobes. Histopathological study of meningeal and brain biopsies showed an inflammatory process that was compatible with HP. The results of an extensive laboratory investigation were unremarkable and did not provide additional information on the cause of the meningeal disease. The patient exhibited relapses despite immunosuppressive therapy. Conclusion. This case shows the challenges associated with the management of the disease and the importance of early diagnosis to avoid worsening of the condition and cerebral damage.


1901 ◽  
Vol 34 (1) ◽  
pp. 81-110 ◽  
Author(s):  
HENRY R. WHARTON
Keyword(s):  

2014 ◽  
Vol 14 (2) ◽  
pp. 200-202 ◽  
Author(s):  
Ammar H. Hawasli ◽  
Thomas L. Beaumont ◽  
Timothy W. Vogel ◽  
Albert S. Woo ◽  
Jeffrey R. Leonard

Acalvaria is a rare congenital malformation characterized by an absence of skin and skull. The authors describe a newborn at an estimated 38 weeks gestational age who was delivered via cesarean section from a 32-year-old mother. Upon delivery, the child was noted to have a frontal encephalocele and an absence of calvaria including skull and skin overlying the brain. A thin membrane representing dura mater was overlying the cortical tissue. After multiple craniofacial operations, including repair of the encephalocele and application of cultured keratinocytes over the rostral defect, the patient demonstrated significant closure of the calvarial defect and was alive at an age of more than 17 months with near-average development.


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